利肺片联合异丙托溴铵治疗支气管哮喘慢性持续期的临床研究

目的探讨利肺片联合异丙托溴铵气雾剂治疗支气管哮喘慢性持续期的临床疗效。方法选择2015年1月—2017年12月武汉市红十字会医院收治的支气管哮喘患者105例为研究对象,按随机数字表法随机分为对照组(52例)和治疗组(53例)。对照组雾化吸入异丙托溴铵气雾剂,2掀/次,2次/d。治疗组在对照组治疗的基础上饭后30 min口服利肺片,2片/次,3次/d。两组均连续治疗14 d。观察两组的临床疗效,比较两组的肺功能指标和血清因子水平。结果治疗后,对照组和治疗组的总有效率分别为84.62%、96.23%,两组比较差异有统计学意义(P0.05)。治疗后,两组用力肺活量(FVC)、1秒用力呼气容积(FEV1)和最大呼气流速(PEF)均显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组肺功能指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清白细胞介素17(IL-17)、白三烯B4(LTB4)、中性粒细胞(PMN)均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组血清因子水平明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论利肺片联合异丙托溴铵气雾剂治疗支气管哮喘慢性持续期具有较好的临床疗效,能改善肺功能,调节IL-17、LTB4水平,降低PMN计数,安全性较好,具有一定的临床推广应用价值。     

金荞麦片联合复方异丙托溴铵治疗支气管哮喘的临床研究

目的探讨金荞麦片联合复方异丙托溴铵治疗支气管哮喘的临床效果。方法选取2017年5月—2018年5月在成都上锦南府医院就诊的支气管哮喘患者148例,根据用药差别进行分为对照组(74例)和治疗组(74例)。对照组患者雾化吸入吸入用复方异丙托溴铵溶液,2.5m L/次,3次/d。治疗组在对照组基础上口服金荞麦片,4片/次,3次/d。两组患者连续治疗15d。观察两组患者临床疗效,同时比较治疗前后两组患者症状积分、ACT评分、血清学指标和不良反应情况。结果治疗后,对照组和治疗组总有效率分别为86.49%和97.30%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者症状积分显著降低(P0.05),ACT评分显著升高(P0.05),且治疗组症状积分和ACT评分明显好于对照组(P0.05)。治疗后,两组患者白细胞介素-4(IL-4)、血清白细胞三烯B4(LTB4)和肿瘤坏死因子-α(TNF-α)水平均显著降低(P0.05),且治疗组血清IL-4、LTB4和TNF-α水平明显低于对照组(P0.05)。治疗期间,治疗组患者不良反应发生率为2.70%,显著低于对照组的13.51%,两组比较差异具有统计学意义(P0.05)。结论金荞麦片联合复方异丙托溴铵治疗支气管哮喘疗效显著、安全性高,且可显著改善患者体内炎症因子水平,具有一定的临床推广应用价值。     

噻托溴铵联合舒利迭对老年支气管哮喘患者中的IL-6、TNF-α及肺功能的影响

目的:探究噻托溴铵联合舒利迭对老年支气管哮喘患者中的IL-6、TNF-α及肺功能的影响。方法:选取某院收治的100例老年重度哮喘患者,按随机数字表法将其分为对照组和观察组各50例,对照组给予噻托溴铵,观察组在此基础上给予舒利迭,两组均治疗1个月,比较两组血清炎症因子、肺功能及生活质量评分。结果:与治疗前对比,治疗后两组IL-8、IL-6、TNF-α水平降低,且观察组低于对照组(P0.05);与治疗前对比,治疗后两组FEV1降低,且观察组低于对照组(P0.05),两组FEV1/FVC%、FVC增加,且观察组高于对照组(P0.05);观察组生活质量评分高于对照组(P0.05)。结论:噻托溴铵联合舒利迭可以降低老年支气管哮喘患者血清炎症因子水平,改善患者肺功能,提高其生活质量。     

异丙托溴铵联合布地奈德雾化吸入治疗支气管哮喘临床效果分析

目的:探讨异丙托溴铵联合布地奈德雾化吸入治疗支气管哮喘的临床效果。方法:选择典型哮喘患者160例,按统计方法随机分为治疗组80例和对照组80例,分别给两组患者基础治疗,对照组加用布地奈德气雾剂,治疗组加用异丙托溴铵联合布地奈德气雾剂,比较两组患者临床效果。结果:治疗前,两组患者各病理情况无显著性差异(P0.05)。治疗后,治疗组患者总有效率97.5%,完全治愈42例、显效31例、好转5例及无效2例;而对照组患者总有效率75%,完全治愈29例、显效19例、好转2及无效30例,差异有统计学意义(P0.01)。结论:异丙托溴铵联合布地奈德雾化吸入能明显改善支气管哮喘患者的肺功能,缓解临床发作症状,疗效确切。     

异丙托溴铵联合舒利迭治疗重度哮喘的疗效分析

目的探讨异丙托溴铵联合舒利迭在治疗重度哮喘患者中的临床效果。方法 80例重度哮喘患者,采用随机数字法分为对照组和实验组,各40例。对照组采用舒利迭治疗,实验组在对照组基础上联合异丙托溴铵治疗。比较两组疗效。结果两组患者治疗前最大呼气量(FEV)、第一秒用力呼气容积(FEV1)以及呼气峰值流速(PEFR)比较,差异无统计学意义(P>0.05);实验组治疗后FEV、FEV1以及PEFR显著高于对照组,差异有统计学意义(P<0.05)。结论重度哮喘患者在舒利迭基础上联合异丙托溴铵治疗效果理想,能够改善患者肺功能,值得临床推广应用。     

龙香平喘胶囊联合噻托溴铵治疗老年支气管哮喘的临床研究

目的探讨龙香平喘胶囊联合噻托溴铵喷雾剂治疗老年支气管哮喘的临床疗效。方法选取2017年10月—2019年10月在平煤神马医疗集团总医院治疗的80例老年支气管哮喘患者,随机分为对照组(40例)和治疗组(40例)。对照组患者吸入噻托溴铵喷雾剂,2揿/次,1次/d。治疗组在对照组的基础上口服龙香平喘胶囊,3粒/次,3次/d。两组患者治疗10 d。观察两组患者临床疗效,比较治疗前后两组患者临床症状消失时间,肺功能指标第1秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC和最大呼气流速峰值(PEFR),血清白细胞介素4(IL-4)、IL-18、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)和干扰素γ(INF-γ)水平及不良反应情况。结果治疗后,治疗组临床总有效率明显高于对照组(P0.05)。治疗后,治疗组患者临床症状消失时间均显著早于对照组(P0.05)。治疗后,两组患者FEV1、FVC、FEV1/FVC、PEFR指标均显著升高(P0.05),且治疗组明显高于对照组(P0.05);治疗后,两组患者IL-4、IL-18、TNF-α、CRP水平显著降低,而INF-γ水平显著升高(P0.05),且治疗组患者血清炎性因子水平明显好于对照组(P0.05)。治疗后,治疗组患者药物不良反应总发生率明显低于对照组(P0.05)。结论龙香平喘胶囊联合噻托溴铵喷雾剂治疗老年支气管哮喘临床效果显著,可有效减轻患者症状,改善肺功能状态及降低炎性因子反应。     

长、短效抗胆碱能药物对轻中度稳定期COPD患者的疗效比较

目的:比较异丙托溴铵气雾剂、噻托溴铵干粉剂治疗轻、中度稳定期慢性阻塞性肺疾病(COPD)患者的疗效。方法:采用随机、单盲、平行对照试验设计,将42例稳定期COPD患者,随机分为噻托溴铵组(每次18μg,qd,吸入)和异丙托溴铵组(每次40μg,qid,吸入),2组疗程均为12周。结果:治疗6周末,2组间肺功能比较差异无统计学意义(P>0.05);治疗12周末,噻托溴铵组第1秒用力肺活量(FEV1)、吸气峰流速(PEF)明显改善,与异丙托溴铵组比较,差异有统计学意义(P<0.05);噻托溴铵组症状评分、机体状况评分及精神状态评分均较异丙托溴铵组显著下降(P<0.05)。结论:噻托溴铵较异丙托溴铵更能改善轻、中度稳定期COPD患者的肺功能,并提高患者的生活质量。     

噻托溴铵治疗老年稳定期慢阻肺患者临床有效率分析

目的:探究噻托溴铵治疗老年稳定期慢阻肺患者临床有效率。方法:将我院收治的68例老年稳定期慢阻肺患者分为异丙托溴铵组(对照组)和噻托溴铵(观察组)各34例,比较两组患者的临床有效率。结果:使用噻托溴铵进行治疗的观察组患者临床治疗总有效率为94.12%,显著高于使用异丙托溴铵治疗的对照组患者的79.41%,肺功能各项观察指标显著优于对照组患者,差异显著(P0.05)。结论:噻托溴铵能够显著提高老年稳定期慢阻肺患者的临床有效率,改善患者肺功能。     

异丙托溴铵雾化吸入辅助治疗儿童哮喘的可行性

目的探讨异丙托溴铵雾化吸入辅助治疗儿童哮喘的可行性。方法选择2016年12月～2018年6月于我院确诊哮喘并进行治疗的患儿130例,按照随机对照分类法分为研究组(n=73)和对照组(n=57)。对照组患儿采用布地奈德加沙丁胺醇雾化吸入进行治疗,而研究组在此基础上加用异丙托溴铵。治疗一周后观察两组患者治疗效果、症状评分、肺功能评价指标、嗜酸性粒细胞百分比、C反应蛋白及血清Ig E指标及不良反应发生情况之间的差异。结果实验组患者治疗好转率明显高于对照组(P 0.05);实验组患者治疗后咳嗽及哮鸣音症状评分明显低于对照组(P 0.05),但两组患者喘息症状评分差异无统计学意义(P0.05);实验组患者治疗后FEV1,PEF及FEV1/FVC均明显高于对照组(P 0.05);实验组患者治疗后Eos%、CRP及Ig E指标均明显低于对照组(P 0.05);两组患儿治疗中均未出现不良反应。结论异丙托溴铵雾化吸入辅助用于儿童哮喘治疗能有效缓解患者症状,缩短治疗周期,其临床应用效果较好,值得推广。     

布地奈德、沙丁胺醇联合异丙托溴铵吸入治疗支气管哮喘急性发作的临床效果观察

目的应用布地奈德、沙丁胺醇联合异丙托溴铵吸入治疗支气管哮喘急性发作,观察治疗后患者临床效果。方法病例选取2014年1月至2016年1月本院收治的120例支气管哮喘急性发作患者,根据治疗方式分成2组,观察组(布地奈德、沙丁胺醇联合异丙托溴铵吸入治疗)和对照组(采用地塞米松磷酸钠注射液治疗),观察两组患者治疗后的临床效果,并记录两组患者胸闷气短、肺部哮鸣音、咳嗽等持续的时间。结果观察组治疗总有效率96.67%,高于对照组86.67%(P<0.05);观察组胸闷气短、肺部哮鸣音、咳嗽等持续时间均少于对照组,组间对比有明显差异,具备统计学意义(P<0.05)。结论在治疗支气管哮喘急性发作时,应用布地奈德、沙丁胺醇联合异丙托溴铵吸入治疗,治疗效果显著,患者临床症状可尽早缓解。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.